IOL Master引导下白内障术后散光和视力影响

目的 观察IOL Master引导下个性化角膜切口白内障超声乳化联合人工晶状体植入术术后散光和视力的变化.方法 选择行3.0mm透明角膜最大屈光轴切口方向白内障超声乳化术术共50只眼,随机分成IOL Master引导下(A组)和自动验光仪及A超引导下(B组)两组,每组25只眼.检测术前、术后1d、1周、1月、3月角膜散光和视力变化.结果 A组术前、术后1d、1周、1月、3月角膜散光度分别为(1.01±0.10)D、(1.33±0.13)D、(1.15±0.14)D、(0.90±0.13)D及(0.89±0.12)D;B组为(0.95±0.13)D、(1.25±0.15)D、(1.07±0.13)D、(0.87±0.12)D及(0.82±0.11)D.术后1d及3月与术前比散光度差异均无统计学意义(P＞0.05).A、B两组术后1d及3月散光度变化量相比差异无统计学意义(P＞0.05).A、B两组术后1d、1周、1月及3月顺规性散光百分率较术前均有所增多,但比较差异均无统计学意义(P＞0.05).A、B两组术后1月和3月裸眼视力＞0.8者分别为8只眼和10只眼、2只眼和3只眼,两者相比差异有统计学意义(P＜0.05).结论 IOL Master引导下角膜个性化切口白内障超声乳化联合人工晶状体植入术有助于患者减少术后角膜散光及视力恢复,且方便可行性高.

Impact on corneal astigmatism and visual acuity in phacoemulsification guided by IOL Master

Objective To study and analyze the impact on corneal astigmatism and visual acuity during individualized phaeoemulsification with intraocular lens implantation guided by IOL Master. Methods Thirty-eight patients (50 eyes) were treated with phacoemulsification through 3.0mm clear corneal incision with the steepest meridian according to IOL Master (group A) or auto-refractor/A-scan (group B). All patients were divided randomly and equally. The corneal astigmatism and visual acuity between group A and B were compared after the operation. Results The astigmatism of group A, B were (1.01± 0.10)D and (0.95 ± 0.13)D before operation, (1.33± 0.13)D and (1. 25 ± 0.15)D 1 day after operation, (1.15± 0.14)D and (1.07 ± 0.13) D after 1 week, (0.90 ± 0.13)D and (0.87 ± 0.12)D after 1 month, (0.89± 0.12)D and (0.80± 0.11)D after 3 months, respectively. There was no significant difference in the estimated values of astigmatism before and after operation (P ＞0.05), so between the methods of IOL Master and auto- refractor (P ＞0.05). In group A the naked visual acuity above 0.8 were 8 eyes 1 month, and 10 eyes 3 months after operation, better than group B with 2 eyes and 3 eyes. There was significant difference in the estimated values of visual acuity between the methods of IOL Master and A-scan (P ＜0.05). Conclusions Individualized phaeoemulsification with intraocular lens implantation guided by IOL Master can reduce corneal astigmatism and improve the visual impact.